Great perspective from Michael L. Barnett, M.D., in NEJM. Sadly, it’s paywalled, but I share a useful table from the article below. Barnett describes the current state of opioid prescribing as an over-correction, in which the terrible opioid overdose epidemic has led public health officials and providers to move too far in the opposite direction.
“…stories are emerging of prescribers abandoning opioids indiscriminately, particularly for the millions of U.S. patients with chronic pain. Like many other public debates, the opioid-prescribing debate seems hopelessly polarized: either opioids are industrially sponsored weapons of mass addiction or they’re a misunderstood last hope for alleviating suffering.”
Barnett details several myths that can drive overprescribing and underprescribing, many of which I’ve personally encountered among health care providers and self-professed experts.
Barnett ML. Opioid Prescribing in the Midst of Crisis — Myths and Realities. New England Journal of Medicine. 2020;382(12):1086-1088. doi:10.1056/nejmp1914257